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SANTIAGO ELIZONDO BENEDETTO
NPI 1336073535
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since June 11, 2026PECOS Enrolled
4590 NASH WAY, SAINT LOUIS, MO 63110(314) 840-6106 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Santiago Elizondo Benedetto NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANTIAGO ELIZONDO BENEDETTO (NPI 1336073535) is an individual student in an organized health care education/training program in Saint Louis, Missouri, licensed in Missouri (2026023535) and active in the NPI registry since June 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336073535
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSANTIAGO ELIZONDO BENEDETTO
Location Address4590 NASH WAYSaint Louis, MO 63110-1020
Mailing Address4590 Nash WaySaint Louis, MO 63110-1020
Phone(314) 840-6106
Sole ProprietorNo
Enumeration DateJune 11, 2026
NPPES CertifiedJune 11, 2026
✔ NPI 1336073535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MO · 2026023535
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4590 NASH WAY, Saint Louis, MO 63110
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Santiago Elizondo Benedetto is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MAUTISUM SAMANA MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 747-3000
AWAB HUSSAIN AHMAD MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 840-6092
MICHAEL COOK CUSUMANO MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 362-7353
ERIN LEEANNE MAYEUX MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 840-6100
DR. CAMERON FRANCIS RUBINO MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY, MAILSTOP: 90-29-928
ST LOUIS, MO 63110
St. Louis City (314) 362-1930
HONGNAN XU
Pathology (Clinical Pathology)
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 362-1935
GHANDI HASSAN MD
Internal Medicine
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 454-8087
KELLY BRAUNE SCHASCHL MD
Student in an Organized Health Care Education/Training Program
4590 NASH WAY
SAINT LOUIS, MO 63110
St. Louis City (314) 362-1930

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Santiago Elizondo Benedetto's NPI number?

The NPI number for Santiago Elizondo Benedetto is 1336073535. It was assigned to this individual provider in the NPPES registry on June 11, 2026.

Where is Santiago Elizondo Benedetto located?

Santiago Elizondo Benedetto practices at 4590 Nash Way, Saint Louis, MO 63110. The listed phone number is (314) 840-6106.

What is Santiago Elizondo Benedetto's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Santiago Elizondo Benedetto enrolled in Medicare?

Yes. Santiago Elizondo Benedetto is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Santiago Elizondo Benedetto was last updated on June 11, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.